Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2022 and Pharmacy Benefit Manager Standards
other · US Department of Health and Human Services · Rule · Published 2021-05-05 · Effective 2021-07-06 · 86 FR 24140
Document
Document number
2021-09102
Federal Register citation
86 FR 24140
CFR reference
45 CFR 147
Type
Rule
Action
Final rule.
Category
other
Sub-agency
US Department of Health and Human Services
Publication date
2021-05-05
Effective date
2021-07-06
HHS docket
CMS-9914-F2
Abstract
This final rule sets forth payment parameters and provisions related to the risk adjustment program and cost-sharing parameters. It includes changes related to special enrollment periods; direct enrollment entities; the administrative appeals processes with respect to health insurance issuers and non-federal governmental group health plans; the medical loss ratio program; income verification by Exchanges; and other related topics. It also revises the regulation requiring the reporting of certain prescription drug information by qualified health plans or their pharmacy benefit managers.